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BIG PHYSICS, BIG QUESTIONS –

Nightmare on Chelmsford, Sydney

By
IAN ANDERSON in
MELBOURNE

Deep-sleep therapy, a controversial treatment for psychiatric illnessess,
led to the death of 24 people in a private hospital in Australia. A Royal
Commission investigating the treatment criticised the medical profession
for not putting a stop to the therapy, which took place over 16 years at
the Chelmsford Private Hospital near Sydney. Three doctors and two hospital
matrons involved in the treatment will face disciplinary hearings next month
before the Medical Tribunal in New South Wales. The doctors could face criminal
charges.

The commission, in its 4000-page report published last month, said the
profession cannot be relied on to keep its own house in order without some
investigative mechanism to take up matters which may involve practitioners
departing from proper practice.

Patients at Chelmsford received large doses of barbiturates and tranquillisers
which kept them sedated or comatose for up to 14 days. It was claimed that
the patient would be in better health, or even cured, after coming out of
the coma. Justice John Slattery, who led the commission, described the treatment
as a very dangerous practice.

Harry Bailey, the doctor who developed the treatment in New South Wales,
once said that the drugs put a patient’s mind on holiday. The drugs, he
said, have very beautiful chemicals that allow us to produce very stylish
results in people’s mental functions. Bailey committed suicide in 1985.

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The commission described Bailey as two-faced, devious, dissembling and
unprincipled. It accused him of a disgraceful breach of all standards of
medicine in relations with female patients, some of whom were brought to
his house in the middle of the night. Bailey had brought the profession
of psychiatry into disrepute, the commission said.

During the treatment at Chelmsford, patients were restrained, often
shackled to the bed, and fed by nasogastric tube. While they were unconscious,
most patients received about 10 electric shock treatments, generally without
any muscle relaxant or anaesthetic, Slatter wrote. Many patients vomited
while unconscious.

Doctors called to give evidence to the commission said that many of
the patients who died were victims of complications brought about by deep-sleep
therapy, such as respiratory problems and oedema caused by barbiturate poisoning.
The stated cause of death was often incorrect, they said. And heavy sedation
was inappropriate for many patients. For example, a 35-year-old woman suffering
from cerebral haemorrhage was given sleep therapy, including shock treatment.
This would have been positively harmful, the commission was told.

Half of those who died, including a 14-year-old boy, were under 40.
All but two of the patients died within 20 days of being admitted to Chelmsford.
They were suffering from a variety of ailments including acute depression,
heroin addiction, alcoholism, schizophrenia and menopausal depression.

Deep-sleep therapy was also linked to brain damage in two patients.
Nineteen other patients committed suicide within a year of receiving the
therapy. A total of 1127 patients received the treatment at Chelmsford between
1963 and 1979.

The therapy was first used after the Second World War, most commonly
in Britain. But, according to the Royal Commission, the therapy was taken
to extremes only at Chelmsford. British psychiatrists did not use the variety
of drugs, nor such large doses, as their Australian counterparts.

Tim Crow, head of the division of psychiatry at the Clinical Research
Centre in Harrow, Middlesex, said he thought most British psychiatrists
would now regard deep-sleep therapy as archaic. ‘I don’t think anyone has
done a serious investigation on it for the past 15 years,’ he said. During
the Second World War, sleep therapy was used in Britain to treat soldiers
suffering from battle shock and more recently it became a fashionable treatment
for schizophrenia.

Crow is not aware of any psychiatrist who uses it now. He said that
Bailey’s combination of deep-sleep and electroconvulsive therapy was even
more bizarre than using deep-sleep therapy on its own.

The Royal Commission was set up in 1988 to investigate complaints against
Chelmsford. Reports of mistreatment of patients date back to 1964, but the
New South Wales Health Department dismissed the complaints as exaggerations.
Its officers accepted the wording on death certificates without making checks.
And they did not properly inspect the area of the hospital where the therapy
was practised.

The commission found that there was a long history of death certificates
being altered and files on patients lost. Bailey signed 17 death certificates
which were probably false. Only 4 of the 24 deaths were investigated by
a coroner.

Slattery urged sweeping changes in the way coroners work in New South
Wales. The police should be notified immediately of any death in a psychiatric
hospital, he said.

Slattery recommended that three doctors closely associated with Chelmsford,
Ian Gardiner, John Herron and John Gill, should be investigated by the state’s
Director of Public Prosecutions. They could face charges related to the
treatment of patients and the falsification of records. The doctors and
two senior nurses, Suzanne Moroney and Sandra Robson, will also be brought
before the state’s Medical Tribunal which can have both the doctors and
nurses struck off the register. Roderick McEwin, a former chairman of the
health department, should also be investigated for giving possible false
evidence to the commission, Slattery said.

Deep-sleep therapy will be banned in New South Wales under a new Mental
Health Act being introduced into state parliament. Former patients at Chelmsford
are angry that the commission did not recommend that the government pay
compensation for what happened and for the inaction of the health department.
Patients are expected to seek redress through the civil courts, but this
could be a long and expensive procedure.